What Are Warts?
Warts are very common non-cancerous growths of the skin caused by infection with human papillomavirus (HPV), a DNA virus. More than 100 HPV subtypes are known, giving rise to a variety of presentations. Skin infection occurs in the superficial layers of the epidermis, causing proliferation of the keratinocytes (skin cells) and hyperkeratosis.
What Cause Viral Warts?
HPV is spread by direct skin-to-skin contact or autoinoculation. This means if a wart is scratched or picked, the viral particles may be spread to another area of skin. The incubation period can be as long as twelve months.
How can Warts be Treated?
Diathermy utilizes an electrical current to cauterize the warts tissue resulting in their destruction subsequent removal. This method is favourable when compared to liquid nitrogen as it is specifically targeted with reduces the likelihood of scarring. 1 – 2 treatments generally suffice to eradicate the wart.
Non ablative lasers such as the Nd:YAG are becoming increasingly popular for treatment of warts due to their ability to specifically target the warts vascular supply and burn the affected tissue within the wart, whilst minimising trauma to surrounding tissue. Laser is often the treatment of choice for warts that have been unresponsive to other treatment options. Treatment number will vary depending on size and location of the wart generally between 2 – 3 treatments.
Either contact cooling, chilled air or topical anaesthetic is used to provide comfort during treatment.
What Happens After Treatment?
Following diathermy the area is cauterised the area becomes inflamed which induces an immune response causing the wart to dry into a crust which generally falls off within 5 – 14 days after treatment. The area may require a second touch up treatment to remove all traces of the Wart, therefore preventing its reoccurrence. However, the immune reaction following treatment is usually efficient enough to remove the Wart.
The treatment of Warts with laser have a similar effect to diathermy treatment.
What is the Long Terms Outlook for Viral Warts?
No treatment is universally effective at eradicating viral warts. In children, even without treatment, 50% of warts disappear within 6 months, and 90% are gone in 2 years. They are more persistent in adults but they clear up eventually. They are likely to recur in patients that are immune suppressed.